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Building Record <br />(please check one) <br />[ }Kew Building Additionn ov�er�5�0�0-{s-q. H. <br />Jurisdiction: �— <br />tease check one' Lfrcity ❑ County — <br />A. Site Information <br />Address /n <br />city Zio 2 J <br />-Lot 7 shy-3-9/ <br />C. If Single Family, Zero Lot Line or D. <br />Planned Unit Development <br />Total Conditioned Floor Area_ <br />WSEO Coovact # <br />(please check one) <br />-BSingle Family ❑ Duplex <br />❑ Multifamily ❑ Zero Lot L <br />B. Owner <br />Attachment B <br />t/ State )/Zip 1�� <br />9772 <br />If Multifamily (R-1) <br />utal # of Buildings <br />Mal # of Units <br />Secondary Space Heat Type C. Water Heat Type <br />A. Primary Space Heat Type (check all t at apply) (check one) �O <br />(check one) iectric r �A <br />❑ lectric Baseboard None <br />{�J Electric Wall Heater �l 14�d ❑GasJq <br />❑ Electric Furnace / ❑ Electric Baseboard El Other (specxy below) "^ <br />❑ Electric Heat Pump ❑ Other (specify below) <br />❑ Other <br />PLIAN ;E INSPECTION/ENFORCEMENT <br />WSEC Compliance <br />❑ Prescriptive F <br />21component F <br />Wj❑ System An <br />o �l 3 <br />This building meets the Date of Permit Application �/- <br />electric Date Suildingi Permit Issued <br />❑ other fuels Date ,)f Insulation Inspection <br />requirements of the WSEC. Date of Final Inspection — <br />I her by certify that this building or addifion has been inspected fc r the measures required <br />by Ole 1991 Washington State Energy Code (WSEC), that it is in substantial compliance <br />with the WSEC, and that the WSEC checklist for this building is on file. <br />Buildin30Hicial or Authorized Representative <br />Date <br />Return canary copy to the servicing electric utility to trigger WSEC compliance payment <br />Return whits copy to Kathleen Skaar, Washington State Energy 011ice P O. Box 43165, Olympia, WA 90504-3165 <br />WSEO lMtita Copy <br />Utility/Owner - Canary Copy Junsdiceon - Pink COPY <br />